Accidents happen, you don't plan for them but you can get a plan that helps cover private hospital costs related to an accident. It even includes rehabilitation treatment, emergency services and emergency casualty cover.
The Hospital Plan has flexible cover for all of this and more.
Flexible levels of cover mean you get to choose your benefit limits to suit your needs and budget.
All hospital costs related to an accident event are covered within your chosen benefit limits. This includes doctors and radiology like MRI and CT scans. You must be admitted to hospital for 24 consecutive hours for the full benefit to apply.
The only limit for your hospital stay is the chosen benefit limit. You are not limited to a specific number of days in hospital, only the benefit amounts chosen.
Also included in the benefit are:
In general, all Hospital claims for planned procedures need to be pre-authorised at least 48 hours before you can use the benefit. This is a simple procedure where we determine whether the procedure you need is covered under your benefits and whether you still have available amounts left over after previous claims.
Accidents may require immediate hospitalisation or result in the person affected being unconscious or otherwise unable to obtain pre-authorisation. In these events, medical personal will always stabilise a patient before being generally admitted, at which point your next of kin can assist with identifying you and your available medical cover.
If you can't practically pre-authorise a hospital visit due to an accident then you must inform EssentialMED within 48 hours about the accident event.
The pre-authorisation procedure is described on the Claims page.
To quote the policy wording:
The definition above helps because it is not only car accidents that apply but also falling, getting bitten by a dog, malaria or other accidental events. But getting cancer, although not intended, is not an accident.
The Accident Hospitalisation benefit is designed to offer generous cover for the treatment of all medical costs related to an accident event.
The Illness Hospitalisation benefit is designed to offer cover for hospital costs that are not related to an accident. You cover can be increased by adding in optional benefits like ICU cover, Dread Disease cover and Maternity cover.
Access private healthcare when you need to see a doctor, visit a dentist, get medication or go to hospital.
Find out how the claims process works for rapid and pain-free claims handling.
There is no waiting period. Accidents are covered immediate from the inception date of your policy.
The benefit doesn't have a specific hospital network and is designed to work with all major hospital groups. The Network page has all the information needed.
Claims are paid directly to the medical providers. You can find all the details on our claims page.
All new members joining a policy must be younger than 65 years on date of application.
Child dependants must be younger than 21 years before they will need to start their own policy.
However, if your child is still a registered full-time student and unmarried, then they may stay on the policy as a child dependant until they turn 26.
Episodic health insurance policies can include:
